Two years after the reauthorization and expansion of the Children’s Health Insurance Program (CHIP), a new Commonwealth Fund state-by-state scorecard evaluating how the health care system is working for children finds that federal and state action on behalf of children has helped preserve, and even expand, health coverage for this group, despite the severe recession.

Yet across the states, wide differences persist in coverage rates, the affordability of health care, children’s receipt of preventive care and treatment, and their opportunity to lead healthy lives. According to the scorecard’s findings, children living in the five top-ranked statesâ€”Iowa, Massachusetts, Vermont, Maine, and New Hampshireâ€”are more likely to be insured and to receive recommended medical and dental check-ups than children living in poorer-performing states like Florida, Texas, Arizona, Mississippi, or Nevada.

In all, the new report analyzes 20 indicators of how the health system is performing for children in each state. An interactive map, meanwhile, enables comparisons among states on individual scorecard indicators, with results downloadable into either PowerPoint or Excel. It also shows the number of lives and dollars each state could save by achieving benchmark levels of performance on select indicators. Also available is a podcast that explores what states can learn from each other, and how health reform will help improve child health systerm performance.

The value of federal and state policies to improve rates of health coverage is evident in the scorecard findings. While coverage rates for parents have declined in 41 states over the past decade, children have fared dramatically better, with rates increasing in 35 states over the same period, thanks to earlier Medicaid expansions, the economic stimulus bill’s Medicaid stabilization funds, and the CHIP expansion and reauthorization.

“The study demonstrates how policies designed to maintain children’s health insurance and access to health care have helped children get the health care they need, especially in tough economic times,” said Cathy Schoen, a senior vice president at The Commonwealth Fund and a coauthor of Securing a Healthy Future: The Commonwealth Fund State Scorecard of Child Health System Performance, 2011. “Yet, because so many parents are uninsured, children and their families will remain at high risk until 2014, when access to health insurance will be expanded to include nearly everyone in the U.S.”